Premium
A Cross‐Sectional Study to Assess the Modulation of Wnt Inhibitors following Anti‐Epileptic Drug Therapy and their Correlation with Vitamin D and Receptor Activator of Nuclear Factor κ B Ligand in Indian Women with Epilepsy
Author(s) -
Parveen Bushra,
Tripathi Manjari,
Vohora Divya
Publication year - 2018
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12996
Subject(s) - sclerostin , medicine , wnt signaling pathway , vitamin d and neurology , endocrinology , calcitriol receptor , osteoporosis , rankl , epilepsy , pharmacology , receptor , activator (genetics) , signal transduction , biology , psychiatry , biochemistry
Long‐term anti‐epileptic drug ( AED ) therapy compromises bone health. Although vitamin D deficiency is proposed to be involved, it alone is not held responsible. This accounts for investigating other mechanisms in bone accrual. Recent studies have shown modulation of inhibitors of wnt pathway, sclerostin and dickkopf‐1 ( DKK ‐1), in glucocorticoids‐induced osteoporosis. We investigated whether AED monotherapy modulates wnt inhibitors in Indian women with epilepsy. Women of age > 20–40 years with the diagnosis of epilepsy and receiving AED s (carbamazepine, valproate and levetiracetam) for at least a year were enrolled. The results were compared with age‐matched healthy controls with no evidence of metabolic bone disease. Women undergoing treatment with AED s (mean duration: 50.59 ± 37.929 months) exhibited higher serum sclerostin and receptor activator of nuclear factor κ B ligand ( RANKL ) and lower vitamin D (25‐hydroxy vitamin D) and DKK ‐1 levels when compared to age‐matched healthy controls. Sclerostin showed a positive correlation with RANKL , while DKK ‐1 presented no such relationship. However, no association was evident after adjusting for age, duration of treatment and total daily dose. Although a correlation between wnt inhibitors and RANKL could not be obtained, AED s displayed changes in serum levels of wnt inhibitors in persons with epilepsy and hence these drugs may compromise bone health through a disturbance in wnt signalling mechanisms.